{"id":6036,"date":"2014-04-28T06:40:24","date_gmt":"2014-04-28T10:40:24","guid":{"rendered":"http:\/\/www.howtocopewithpain.org\/blog\/?p=6036"},"modified":"2025-09-04T14:05:59","modified_gmt":"2025-09-04T18:05:59","slug":"medications-for-pain-series-anticonvulsants-2","status":"publish","type":"post","link":"https:\/\/www.howtocopewithpain.org\/blog\/6036\/medications-for-pain-series-anticonvulsants-2\/","title":{"rendered":"Medications for Pain Series:  <i>Anticonvulsants<\/i>"},"content":{"rendered":"<div id=\"r1PostCPBlock\" style=\"border: currentColor; left: -99999px; text-align: left; color: #000000; overflow: hidden; text-decoration: none; position: absolute; background-color: #ffffff;\">\n<p>This article is\u00c2\u00a0in our series on <strong>Medications for Pain<\/strong>\u00e2\u20ac\u00a6\u00c2\u00a0 what are your choices?\u00c2\u00a0 how do various medications work?\u00c2\u00a0 what are the pros and cons?\u00c2\u00a0 how about side effects?<\/p>\n<p>The class of medication we\u00e2\u20ac\u2122re looking at today is called <strong><em>Anticonvulsants<\/em><\/strong>, which are medications originally used to treat seizure disorders.\u00c2\u00a0 Within this class, there are:<\/p>\n<ol>\n<li>\u00e2\u20ac\u0153<em>1st generation<\/em>\u00e2\u20ac\u009d anticonvulsants, which are simply older medications.\u00c2\u00a0\u00c2\u00a0Tegretol and Dilantin are in this group.<\/li>\n<li>\u00e2\u20ac\u0153<em>2nd generation<\/em>\u00e2\u20ac\u009d anticonvulsants, which are simply newer medications.\u00c2\u00a0\u00c2\u00a0Medications such as Neurontin, Lyrica, and Topamax are in this group.<\/li>\n<\/ol>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" title=\"pills\" src=\"http:\/\/www.psychtreatment.com\/j0315446.jpg\" alt=\"\" width=\"286\" height=\"163\" \/><\/p>\n<p><strong>Effect of Anticonvulsants<\/strong>:\u00c2\u00a0 Anticonvulsants work by decreasing the hyper-excitability of nerves, and so decrease how easily pain signals are transmitted.<\/p>\n<p><strong>Uses of Anticonvulsants<\/strong>:\u00c2\u00a0 Because anticonvulsants work by slowing down nerve signals, they\u00e2\u20ac\u2122re helpful in disorders that have overly-excited nerves.\u00c2\u00a0 So they work best in \u00e2\u20ac\u0153nerve pain,\u00e2\u20ac\u009d which is called <em>neuropathic<\/em> pain.\u00c2\u00a0 They don\u00e2\u20ac\u2122t work as well in other pain disorders, for example pain caused by inflammation.<\/p>\n<p>\u00e2\u20ac\u0153<strong>Neuropathic pain<\/strong>\u00e2\u20ac\u009d is pain caused by problems in the\u00c2\u00a0nerves running through the body (\u00e2\u20ac\u0153peripheral\u00e2\u20ac\u009d nerves), or in the brain or spinal cord.\u00c2\u00a0\u00c2\u00a0Some examples would be:<\/p>\n<ul>\n<li>Pain after amputation \u00e2\u20ac\u201c nerves are cut and damaged with surgery<\/li>\n<li>Spinal problems, such as herniated disks \u00e2\u20ac\u201c pieces of spine are pushing on nerves as they leave the spinal cord<\/li>\n<li>Microscopic damage to nerves in the body, such as occurs in diabetes (called diabetic peripheral neuropathy) or shingles (called post-herpetic neuralgia)<\/li>\n<\/ul>\n<p>What\u00e2\u20ac\u2122s most <em>interesting<\/em> about anticonvulsants is that they work in disorders where we might not expect them to work.\u00c2\u00a0 An example is fibromyalgia, which used to be thought of as an inflammatory disorder, or even a psychological disorder.\u00c2\u00a0 But anticonvulsants help in fibromyalgia!\u00c2\u00a0 What this tells us\u00c2\u00a0is that fibromyalgia is, at least partly, neuropathic pain.\u00c2\u00a0 This is an<em> important<\/em> advance, not just in treating fibro, but in understanding other pain disorders.<\/p>\n<p>We now also know that there are\u00c2\u00a0<a href=\"http:\/\/www.howtocopewithpain.org\/blog\/69\/it-is-a-real-disorder-what-brain-studies-tell-us-about-fibromyalgia\/\"><span style=\"color: #003399;\">changes in the brains of patients with fibromyalgia <\/span><\/a>that make them more likely to experience pain.\u00c2\u00a0 So recent brain studies confirm what responding to anticonvulsants suggests \u00e2\u20ac\u201c this disorder is partly neuropathic.\u00c2\u00a0 Pretty neat convergence of brain studies and medication response!<\/p>\n<p><strong>What medications work<\/strong>?\u00c2\u00a0 Some examples of FDA-approved medications:<\/p>\n<ul>\n<li>Lyrica in diabetic neuropathy and fibromyalgia<\/li>\n<li>Neurontin in shingles (post-herpetic neuralgia)<\/li>\n<li>Tegretol in trigeminal neuralgia<\/li>\n<\/ul>\n<p><strong>Medical Studies<\/strong>:\u00c2\u00a0 Anticonvulsants\u00c2\u00a0are pretty well studied in various pain disorders, and they help in a wide range of disorders.\u00c2\u00a0 What\u00e2\u20ac\u2122s important to remember is that only <em>some<\/em> medications have been studied in<em> some<\/em> disorders, and have been\u00c2\u00a0FDA-approved.\u00c2\u00a0 But that doesn\u00e2\u20ac\u2122t mean that a medication won\u00e2\u20ac\u2122t be helpful for a disorder it\u00e2\u20ac\u2122s not formally approved for \u00e2\u20ac\u201c for example, Lyrica <em>may<\/em> help in shingles.\u00c2\u00a0 It just may not have been studied yet.\u00c2\u00a0 (<a href=\"http:\/\/www.howtocopewithpain.org\/blog\/134\/medication-101-what-are-my-options-for-pain-treatment\/\"><span style=\"color: #003399;\">Click here for a discussion on FDA-approved medications versus \u00e2\u20ac\u0153just guessing\u00e2\u20ac\u009d<\/span><\/a>.)<\/p>\n<p>Your doctor should tell you if a medication she\u00e2\u20ac\u2122s recommending is FDA-approved or not, and if not, how much it\u00e2\u20ac\u2122s been studied for your disorder.<\/p>\n<p><strong>Side Effects<\/strong>:<\/p>\n<ul>\n<li>sedation (which can be helpful for sleep)<\/li>\n<li>tissue swelling<\/li>\n<li>weight gain<\/li>\n<li>cognitive interference \u00e2\u20ac\u201c some patients call this \u00e2\u20ac\u0153Neurontin head\u00e2\u20ac\u009d<\/li>\n<li>1st generation anticonvulsants can have more serious side effects, including effects on blood cells.<\/li>\n<\/ul>\n<p>Anticonvulsants\u00c2\u00a0<strong>should\u00c2\u00a0not<\/strong> be stopped quickly, as this, though rare, can cause seizures.<br \/>\nRead more at <a style=\"color: #003399;\" href=\"http:\/\/www.howtocopewithpain.org\/blog\/3090\/anticonvulsants-for-pain-2010\/#Q9m4XqYYd4KBwZ6q.99\">http:\/\/www.howtocopewithpain.org\/blog\/3090\/anticonvulsants-for-pain-2010\/#Q9m4XqYYd4KBwZ6q.99<\/a><\/p>\n<\/div>\n<p style=\"text-align: center;\"><em>This article is\u00a0in our series on <strong>Medications for Pain<\/strong>. What are your choices? how do various medications work? what are the pros and cons? how about side effects?<\/em><\/p>\n<p><strong><em>Anticonvulsants <\/em><\/strong>are medications originally used to treat seizure disorders. Within this class, there are:<\/p>\n<ol>\n<li><em>1st generation<\/em>\u00a0anticonvulsants, which are simply older medications.\u00a0Tegretol and Dilantin are in this group.<\/li>\n<li><em>2nd generation<\/em>\u00a0anticonvulsants, which are simply newer medications.\u00a0Medications such as Neurontin, Lyrica, and Topamax are in this group.<\/li>\n<\/ol>\n<p style=\"text-align: center;\"><strong>Effect of Anticonvulsants<\/strong>: Anticonvulsants work by decreasing the hyper-excitability of nerves, and so decrease how easily pain signals are transmitted.<\/p>\n<p><strong>Uses of Anticonvulsants<\/strong>: Because anticonvulsants work by slowing down nerve signals, they&#8217;re helpful in disorders that have overly-excited nerves. So they work best in nerve pain, which is called <em>neuropathic<\/em> pain. They don&#8217;t work as well in other pain disorders, for example pain caused by inflammation.<\/p>\n<p><strong>Neuropathic pain <\/strong>is pain caused by problems in the nerves running through the body (peripheral nerves), or in the brain or spinal cord. Some examples would be:<\/p>\n<ul>\n<li>Pain after amputation (nerves are cut and damaged with surgery)<\/li>\n<li>Spinal problems, such as herniated disks\u00a0(pieces of spine are pushing on nerves as they leave the spinal cord)<\/li>\n<li>Microscopic damage to nerves in the body, such as occurs in diabetes (diabetic peripheral neuropathy) or shingles (post-herpetic neuralgia)<\/li>\n<\/ul>\n<p>What&#8217;s most interesting\u00a0about anticonvulsants is that they work in disorders where we might not expect them to work. An example is fibromyalgia, which used to be thought of as an inflammatory disorder or even a psychological disorder. Because\u00a0anticonvulsants work, we now understand\u00a0that fibromyalgia is, at least partly, neuropathic pain. This is an important advance, not just in treating fibro, but in understanding other pain disorders.<\/p>\n<p>We now also know that there are\u00a0changes in the brains of patients with fibromyalgia that make them more likely to experience pain. So recent brain studies confirm what responding to anticonvulsants suggests &#8211;\u00a0this disorder is partly neuropathic.<\/p>\n<p><strong>What medications work<\/strong>? Some examples of FDA-approved medications:<\/p>\n<ul>\n<li>Lyrica in diabetic neuropathy and fibromyalgia<\/li>\n<li>Neurontin in shingles (post-herpetic neuralgia)<\/li>\n<li>Tegretol in trigeminal neuralgia<\/li>\n<\/ul>\n<p><strong>Medical Studies<\/strong>: Anticonvulsants\u00a0are pretty well studied in various pain disorders, and they help in a wide range of disorders. What&#8217;s important to remember is that only <em>some<\/em> medications have been studied in<em> some<\/em> disorders, and have been\u00a0FDA-approved. But that doesn&#8217;t mean that a medication won&#8217;t be helpful for a disorder it&#8217;s not formally approved for.\u00a0 For example, Lyrica <em>may<\/em> help in shingles. It just may not have been studied yet. Your doctor should tell you if a medication she&#8217;s recommending is FDA-approved or not, and if not, how much it&#8217;s been studied for your disorder.<\/p>\n<p><strong>Side Effects<\/strong>:<\/p>\n<ul>\n<li>sedation (which can be helpful for sleep)<\/li>\n<li>tissue swelling<\/li>\n<li>weight gain<\/li>\n<li>cognitive interference (some patients call this &#8220;Neurontin head&#8221;)<\/li>\n<li>1st generation anticonvulsants can have more serious side effects, including effects on blood cells.<\/li>\n<\/ul>\n<p>Anticonvulsants\u00a0<strong>should\u00a0not<\/strong> be stopped quickly, as this\u00a0can cause seizures.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This article is\u00c2\u00a0in our series on Medications for Pain\u00e2\u20ac\u00a6\u00c2\u00a0 what are your choices?\u00c2\u00a0 how do various medications work?\u00c2\u00a0 what are the pros and cons?\u00c2\u00a0 how about side effects? The class of medication we\u00e2\u20ac\u2122re looking at today is called Anticonvulsants, which are medications originally used to treat seizure disorders.\u00c2\u00a0 Within this class, there are: \u00e2\u20ac\u01531st generation\u00e2\u20ac\u009d [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6036","post","type-post","status-publish","format-standard","hentry","category-1"],"_links":{"self":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts\/6036","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/comments?post=6036"}],"version-history":[{"count":5,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts\/6036\/revisions"}],"predecessor-version":[{"id":8037,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/posts\/6036\/revisions\/8037"}],"wp:attachment":[{"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/media?parent=6036"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/categories?post=6036"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.howtocopewithpain.org\/blog\/wp-json\/wp\/v2\/tags?post=6036"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}